HomeMy WebLinkAboutVALLEY VIEW ESTATES TR 2c) f A I k"I I A
Municipality of Anchorage
On -Site Water and Wastewater Section - (907) 343-7904 Page 1 of 3
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP1 81003 PID Number: 050-521-09
Dwelling: RE Single Family (SF) R with ADU El Duplex (D) El Two Single Family Project: RN New El Upgrade
Name
DAVID CURTIS
ABSORPTION FIELD
R Deep Trench 9 Wide Trench R Bed R Mound
Site Address
25761 CRYSTAL CREEK DRIVE, EAGLE RIVER, AK
❑ Other
Phone
Number of Bedrooms
Soil Rating
depth from original grade
(703)835-1174
3
0.8 GPD/SF
JTotal
SEE DWG. Ft,
LEGAL DESCRIPTION
Depth to pipe invert from original grade
SEE DWG. Ft,
Gravel depth beneath pipe
0,65'/ 0.65' Ft,
Subdivision Block Lot
VALLEY VIEW ESTATES - TRACT
Fill added above original grade
SEE DWG. Ft.
Gravel length
120'(60'/ 60 Ft.
Township Range Section
Gravel width
5 Ft.
Beds: Number
of Lines
Distance between lines
Ft.
SEPARATION
DISTANCES
To
Septic
Absorption
Lift Station
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Tank
Line
600 Ft2
2
6+ Ft,
Well
100'+
100'+
-
-
25'+TANK
9 Septic El S.T.E.P. 0 Holding 171 Other
'Manufacturer
- GREERTANK
Capacity
**1500 Gal.
Surface Water
1001+1
100'+
-
-
Material
Number of compartments
Lot Line
5+
*51+
-
-
NA
PLASTIC
2
Foundation
10'+
10'+
-
-
)N
Manufacturer Capacity
Remarks *LOT LINE WAIVER GRANTED (OSVI 71006)
Gal.
Alarm location Elect al ed by
**OWNER INSTALLED LARGER SIZE TANK THAN NEEDED.
Installer
PIPE MATERIAL House to tank D3034 Tank to D3034
drainfield
OWNER
Drainfleld D3034 GO/MT D3034
Inspector GEG
BENCHMARK (Assumed elevation) 155.52 ft
Inspdates: ection 1st 6/22-23/17 2nd 6/24/17
Location and description
V 6/28-30/17 4117/21/18
TOP OF MANHOLE (MH1)
ON-SITE WATER AND WASTEWATER SECTION APPROVAL
Engineer's Stamp
Conditional Approval: Date
4
. ..................
Septic System
f A. G ness.-'
Approved Date 2 1 A5_
C
Q4p o
Note: this approva �Zoes not include well permit requirements.aa
Pr ofe Sko
ECC8
t v. UUJV41 0)
PERMIT NUMBER: PARCEL ID NUMBER:
OSP181003 _ _0ECORD DRAWING 050-521-09
i
.. / \
100' WELL RADIUS
• r NEW f
WELL
NOTE: RESERVE SITE IS
FCO
27.6
5.6
MH1
55.3
38.9
-
STI
57,8
43.1
-
DBL1
60.6
47.6
-
OBL2
61.2
48.7
-
COI
79.3
72.7
-
0O2
107.7
90.9
128.5
CO3
1501
127.9
160.8
FS
136.6
149.2
C04
OWNER/CONTRACTOR. / z dINSTALLED DOUBLE
127.2
147.6
MT1
'
125.2
145.4
C05
137.6
142.2
MT2
139.5
144.1
C06
54
140.1
161.1
MT3
138.2
158,9
C07
156.2
1.
163.1
MT4
\
156.9
164.2
I
'w 's• 1
GARNESS ENGINEERING GROUP, Ltd ••.t •..4 • • •• ...............A.....
VZOOMMUMM ENGINEERING o SALES,, CONSULTING 1
3701 E. TUDOR ROAD, SURE 101 • ANCHORAGE, AK 99507 -PHONE (907) 337-0179' FAX (907) 3383248' WEBSITE: www.gamemnginoodng.cwn `•■ . ■n..u•■. •.•un••un. ..�
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ey mess
DAVID CURTIS 703-835-1174 2 OF 3 C -7953 •'° •�►
PROJECT&EGAL DESCRIPTION: DRAWN BY: ��. •. t( ( 'l �.•••• +1
VALLEY VIEW ESTATES S/D; TRACT 2 J.L.M. IFQ .....
TYPE OF WORK: DATE: LICENSE,1��t"5,�,� ��♦
RECORD DRAWING OF NEW SEPTIC SYSTEM 10/30/2024 #AECC884
•-
THE REBUILDING OF THE%• • ' Y �O NOTE: PIPE LOCATIONS ARE SHOWN
,","„ �
EXISTING DRAIN ? • `�.+ ,. �;. OGi1,00 PER KENNETH G LANG, RPLS
;.:; ,. , •'. F :f, ASBUILT SURVEY DATED 02119/2021.
1
1
SWING -TIES TO HOUSE CORNERS
a. •...:.:• o WERE GENERATED IN AUTOCAD.
DRAINSOCK. (APPROX. LOCATION) •�• FG � I
i
INSTALLED IN THE SPRING/NEW GREER 1500 GALLON
I
SUMMER OF 2018 BY OWNER, PLASTIC SEPTIC TANK. i
2 - V TANK MONITORING (
INSULATED UNDER DRIVEWAY WITH •, } : • TUBES INSTALLED. ONE OF '
i
�, ; • . UPHILL SIDE OF TANK AND ONE '
\ 4" OF INSULATION BY 4 FEET WIDE,' =
1
•, ON DOWNHILL SIDE OF TANK I
CENTERED OVER PIPE PER THE
i
OWNER/CONTRACTOR. / z dINSTALLED DOUBLE
I
CLEANOUTS (DBL7 & DBL2)
i
'
Go w� •�••I
I
54
''
•'.
INSTALLED FLOW \ \\ '!•�• .•. • . °o
\\ \\ " �. -
1
SPUTTER (FS) ., • - x y
\
/ CO
I
w
Iwww
w Q� •�'•.•�•• f:.,,.. i
1
/ ww •w
I
ww U06
1 NEW DRAINFIELDS
V LOT LINE WAIVER GRANTED
- - - - - -
' CRYSTAL CREEK DRIVE (UNDEVELOPED)
APPROXIMATE
BOUNDARY '
OF FILL AREA OWNER OBTAINED ENCROACHMENT PERMIT (PERMIT # R171134) FROM
MOA RIGHT-OF-WAY DEPARTMENT TO PLACE FILL IN RIGHT -OF -WAY N
-----------------------r-------------
NOTE: ANY DAYLIGHTING OF GROUNDWATER THAT WAS CREATED BY THE
INSTALLATION OF THE ACCESS DRIVEWAY WITHIN 100 FEET OF THIS SEPTIC SCALE:
SYSTEM OR ANY NEIGHBORING SEPTIC SYSTEMS HAS BEEN MADE SUBSURFACE. 1"= 50
f
'w 's• 1
GARNESS ENGINEERING GROUP, Ltd ••.t •..4 • • •• ...............A.....
VZOOMMUMM ENGINEERING o SALES,, CONSULTING 1
3701 E. TUDOR ROAD, SURE 101 • ANCHORAGE, AK 99507 -PHONE (907) 337-0179' FAX (907) 3383248' WEBSITE: www.gamemnginoodng.cwn `•■ . ■n..u•■. •.•un••un. ..�
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ey mess
DAVID CURTIS 703-835-1174 2 OF 3 C -7953 •'° •�►
PROJECT&EGAL DESCRIPTION: DRAWN BY: ��. •. t( ( 'l �.•••• +1
VALLEY VIEW ESTATES S/D; TRACT 2 J.L.M. IFQ .....
TYPE OF WORK: DATE: LICENSE,1��t"5,�,� ��♦
RECORD DRAWING OF NEW SEPTIC SYSTEM 10/30/2024 #AECC884
NOTE: PER GEG SITE VISIT ON 10/10/2024, ALL SLOPES
OVER AND BELOW DRAINFIELD AREA ARE NOW WELL
VEGETATED AND IT APPEARS ALL SLOPES ARE LESS THAN
2: 1. NO DAYLIGHTING OF EFFLUENT WAS OBSERVED.
seY
PERMIT NUMBER: PARCEL ID NUMBER:
OSP181003 Krmw&EcoKu DRAWING 050-521-09
TOP OF MANHOLE
/A At I A% — A tr_" R-^ FINAL GRADE RTI
LOWER TRENCH
FINAL GRADES BASED UPON GEG
ELEVATIONS ON 10/10/2024 = 99.15-99.79--n
2" OF INSULATION (PER CONTRACTOR)
03
FILTER FABRIC -- C
-% tftfl"
w
z
I
CL
MT3
MT4
SAND :-!V."i..'
now
[-40-5'+ (SEE NOTE) -ow.
UPPER TRENCH
FINAL GRADES BASED UPON GEG
ELEVATIONS ON 10/10/2024 = 103.11-103.44
2" OF INSULATION
(PER CONTRACTOR)- MT1 C01
MT2 CO2
FILTER FABRIC--, m m
ks 140i e)
-ORIGINAL GRADE @
HIGHEST POINT = 94.23
`*—INVERT OF
DISTRIBUTION
LINE = 94.90
TOP OF SAND
61 FILTER = 94.25
51
(SEE NOTE)
INVERT OF DISTRIBUTION
LINE = 99.15
-TOP OF SAND FILTER = 98.50
MAXIMUM DEPTH ON
UPHILL SIDE = 97.00 / ON
DOWNHILL SIDE = 96.50
(ALL ORGANICS REMOVED)
BEDROCK AT 6 FEET. DRY TO 6 FEET ON 6/22/2017
MAXIMUM DEPTH ON
UPHILL SIDE = 92.23 / ON
OWNER OBTAINED A ENCROACHMENT PERMIT FROM MOA DOWNHILL SIDE = 91.83
RIGHT-OF-WAY DEPARTMENT TO PLACE FILL IN RIGHT -OF -WA (ALL ORGANICS REMOVED)
M A PRI RY SITE PROFILE DETAIL RECORD DRAWISCALE:
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%FESS\
LICENSE 4141kyA
#AECC884
Certified Drilling Log
OWNER OF LAND: Michael “David” Curtis
ADDRESS:
LEGAL DESCRIPTION Valley View Estates Tract 2
DATE: 6-15-18
PERMIT
NUMBER:
OSP181003 DATE OF ISSUE: 1-19-18
TAX IDENTIFICATION
NUMBER 05052109000
Is well located at approved permit location: Yes No
Method of Drilling: air rotary cable tool
Depth of Well: 184’
Casing Type: Steel Wall thickness .250 inches
Diameter: 6 inches, depth 44 feet
Liner type 140’ of 4.5” PVC
Static Water Level: 32 feet
Recovery Rate 15 gpm gph
Method of Testing Air
Well Intake Opening Type: open end open hole
Screened Start feet Stopped
Perforations Start feet Stopped
Grout Type: Bentonite Volume: 200 lbs
Depth: from 2 feet, to 42 feet
Well Disinfected Upon Completion: yes no
Method of Disinfection: Chlorine 50 PPM
Comments:
Shallow bedrock – Surface seal per MOA code.
Bore Hole Data
Depth
From To
0 2 Casing Stickup
2 4 Overburden
4 62 Bedrock Gray
62 71 Bedrock Yellow Broken
71 100 Bedrock Hard Green
100 104 Bedrock Yellow Broken
104 168 Bedrock Hard Green
168 171 Bedrock Heavily Fractured Gray
171 179 Bedrock Hard Green
179 182 Bedrock Broken Dark Gray
182 184 Bedrock Hard Green
Drillers Name: Cole Sullivan
ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority. Municipality
of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation. MatSu Borough:
Department of Environmental Conservation.
www.sullivanwaterwells.com
Pump Installation Log
Well Drilling Permit Number: OSP 181003 Date of Issue 1-19-18
Parcel Identification Number: 05052109000
Legal Description Property Owner Name & Address
Valley View Estates Tract 2 Michael “David” Curtis
Pump Installation Date:
6-21-18
Pump Intake Depth Below Top of Well Casing:
130 feet
Pump manufacturer’s Name:
F&W
Pump Model:
4F11A07301
Pump Size:
¾ hp
Pitless Adapter Burial Depth:
10 feet
Pitless Adapter Installer:
Pitless Manufacturer:
Unknown
Disinfected Upon Completion?
yes no
Method of Disinfection:
Chlorine 50 PPM
Comments:
Pump Installers Name:
Sullivan Water Wells
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.
Unknown
I
I
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
http://www.muni.org/onsite
On -Site Wastewater Disposal System Permit
Permit Number: OSP201005
Work Type: Septic Renewal
Tax Code Number: 05052109000
Site Legal Address: VALLEY VIEW ESTATES TR 2 G:0263
Site Mailing Address: 25761 CRYSTAL CREEK DR, Eagle River
Owner: CURTIS MICHAEL
Design Engineer: GARNESS ENGINEERING GROUP LTD
This permit is for the construction of:
Effective Date
Expiration Date:
Lot Size in Sq Ft
Total Bedrooms:
nt
Departnient
1/17/2020
1/16/2021
425700
Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction shall be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80)
3. The wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
Special Provisions:
1. Awell log, pump install log and water sample results for total coliform, nitrates and arsenic are required to be
submitted to close out this permit (for well drilled under OSP181003).
.1
2. The septic tank shall have a minimum 20" manway riser to the first compartment.
Received By: Date:
Issued By: �J I°iCC1� �SZn� Date: / >
7 ,
3
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 05D - 5 2 I— O
Property owner(s) 1 ' t 1 Ck to S Day phone
Mailing address S+Cee +
Site address ` r
Legal description (Sub'd., Block & Lot) V, V yew &&S4" �r z
Legal description (Township, Range & Section)
Lot Size Sq. Ft. Number of Bedrooms 9
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field
Initial ❑
Single Family (SF)
Septic Tank
Upgrade ❑
(w/wo AD U)
Duplex (D)
❑
Holding Tank
❑
Renewal
Multiple Dwellings
❑
Privy
❑
(SF and/or D)
Private Well
❑
Water Storage
❑
THIS APPLICATION INCLUDES A WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit/Rush Fees: "[ S-�n�
Date of Payment: 1/1 [f o ORD
Receipt Number: IM fl b5A 3
Permit No. O&Pw do S
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc
"
ol � rY MUNICIPALITY OF ANCHORAGE
%� .
� lel l' Il C .
On -Site Water &Wastewater Program
1 PO Box 196650 4700 Elmore Road
9 Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 kw.
http://www.muni.org/onsite
l)eh<trtIII ent
On -Site Wastewater Disposal System Permit
Permit Number: OSP191006 Effective Date: 1/11/2019
Work Type: Septic Renewal Expiration Date: 1/11/2020
Tax Code Number: 05052109000
Site Legal Address: VALLEY VIEW ESTATES TR 2 G:0263
Site Mailing Address: 25761 CRYSTAL CREEK DR, Eagle River
Owner: CURTIS MICHAEL Lot Size in Sq Ft: 425700
Design Engineer: GARNESS ENGINEERING GROUP LTD Total Bedrooms: 3
This permit is for the construction of:
Q Disposal Field 10 Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction shall be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80)
3. The wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
Special Provisions: If well has been drilled, a well log, pump install log and water sample results for total
coliform, nitrates and arsenic are required to be submitted to close out this permit.
Received By: Date: I� q
Issued By: �,{� �(� j'tJ Date:
MUNMPAUTY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section --� Fax: 907-343-7997
ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. o S-0-52,) —G1
Property owner(s)M e_o) C (4/' -fl S Day phone v
Mailing address Z Z ,.�3 ( oXe S-t`leefi
Site address fil^G�GrR Z (fA le ✓���-ems
Legal description (Sub'd., Block & Lot) ! (Aj 1eG t/+ ety CS -fa Tr 2
Legal description (Township, Range & Section)
Lot Size
Sq. Ft. Number of Bedrooms 3
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(N all that apply)
09_7
Absorption Field
Initial
Single Family (SF)
Septic Tank
Upgrade El(w/wo
ADU)
Duplex (D)
❑
Holding Tank
❑
Renewal K
Multiple Dwellings
❑
Privy
❑
(SF and/or D)
Private Well
❑
Water Storage
❑
THIS APPLICATION INCLUDES A WAIVER REQUEST FOR:
yDistance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit/Rush Fees: /IS / NO
Date of Payment: l ($ 19
Receipt Number: # a333
Permit No. fis(�U
_Vtv"V�
Waiver Fees: "� C��l
Date of Payment: .1 }a) q q
Receipt Number: (j, s
Waiver No. 6 S\/ III � Uv t_'?
GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client FormsTermit Application.doc
oC"L""TY MUNICIPALITY OF ANCHORAGE
// t '�
On-Site Water&Wastewater Program 5•
PO Box 196650 4700 Elmore Road
Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997
http://www.muni.orgionsite
\ J/ 1),•11artmum
�NCNOF pG�
On-Site Water & Wastewater System Permit
Permit Number: OSP181003 Effective Date: 1/19/2018
Work Type: WellSeptic Renewal Expiration Date: 1/19/2019
Tax Code Number: 05052109000
Site Legal Address: VALLEY VIEW ESTATES TR 2 G:0263
Site Mailing Address:
Owner: CURTIS MICHAEL Lot Size in Sq Ft: 425700
Design Engineer: GARNESS ENGINEERING GROUP LTD Total Bedrooms: 3
This permit is for the construction of:
Disposal Field Q Septic Tank ❑ Holding Tank 0 Privy El Private Well 0 Water Storage
All construction shall be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72)and Drinking Water Regulations (18AAC80)
3. The wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
Q
Received By: `� / 9 Date: U
Issued By: A. // rd
l , , Date:
MUNICIPALITY OF ANCHORAGE
Community Development Department Phone: 907-343-7904
Development Services Division Fax: 907-343-7997
On-Site Water &Wastewater Program
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. OC I
Property owner(s) ''CIV > C C tirl" S Dayphone >o3 as )!
p Y
Mailing address I22(3 I c 1 s-trey°
Site address To6f Z ec�le (7v�',/ _
Legal description (Sub'd., Block & Lot) 1/&)/ej� V� e1 es f. � r v
Legal description (Township, Range & Section)
Lot Size Sq. Ft. Number of Bedrooms 3
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(®all that apply)
Absorption Field [I Initial ] Single Family (SF)
(w/wo ADU)
Septic Tank Eik Upgrade ❑ Duplex (D) ❑
Holding Tank ❑ Renewal ❑
Multiple Dwellings ❑
Privy ❑ (SF and/or D)
Private Well
Water Storage El
THIS APPLICATION INCLUDES A VARIANCE/WAIVER REQUEST FOR:
J WLw(Al'kee / Lot f'h c/Nve/ Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit/Rush Fees: 'Pk.oet.J00 Waiver Fees:
Date of Payment: f Date of Payment: 2-/10117
Receipt Number: Receipt Number: 0
Permit No. OSPIQIOCt3 Waiver No. CSV 111 OG(0
Permit App_9-1-12.doc
,"tnt .S
it .^ Municipality of Anchoragll
e .
,\` � Department
P.O. Box 196650 a 4700 Elmore Road
Anchorage, Alaska 99519-6650 • (907) 343-7904 I Fax(907) 343-7997
http://www.muni.orq/Onsite
Development Services Division
On-Site Water and Wastewater Program
**** VARIANCE/WAIVER REVIEW ***
Waiver#: OSV171006 COSA#: Permit#: OSP171011
PID#: 050-521-09
Legal Description:Valley View Estates Tract 2
Engineer: Garness Engineering Group
Applicant: Michael Curtis
Your request for a waiver of the required 50 feet horizontal separation from the absorption field
to the excessive slope has been approved. The approved separation distance is 0.0 feet. In
addition, your request for a waiver of the required 10 feet horizontal separation from the
absorption field to the lot line has been approved. The approved separation distance is 5.0 feet.
See engineer's letter and profile drawing for waiver justifications.
This waiver approval applies to the proposed absorption field only. Any future upgrade to the
on-site wastewater disposal system will require all separation distances be met or another
approval from this department.
n The affected adjacent property owner(s) ,have been given a 7 day notice regarding this
waiver.
n Notarized letter(s) of nonobjection have been received from the owner(s) of the affected
adjacent property.
V1 Adjacent properties are not affected by this waiver.
•
t
Waiver is Granted: X Waiver is not Granted:
Date: o(la 20/ 7 Approved by: iiie..ca e'a ClUzit 6--(//
Name of Reviewer
**** VARIANCE/WAIVER REVIEW ****
.�•' """` Municipality of Anchorage
On-Site Water and Wastewater Program
P.O.Box.196550 4700 Elmore Road r,
Anchorage Alaska 995196650 Phone:(907)343.7904 Fax 1907}343-7907 .
thtto:Iwww.muni.orefonsite a
pai tn►c°nI
Permit Number: OSP171011 Effective Date: 2/27/2017
Tax Code Number: 05052109000 Expiration Date: 2/27/2018
Work Type: WellSeptic Initial (0/22i I^1 SO)-1
Design Engineer: GARNESS ENGINEERING GROUP LTD
Site Legal Address: VALLEY VIEW ESTATES TR 2 G:0263
Owner: CURTIS MICHAEL
Site Mailing Address:
Lot Size in Sq Ft: 425700
Total Bedrooms: 3
This permit is for the construction of:
Q Disposal Field Q Septic Tank 0 Holding Tank ❑ Privy 0 Private Well 0 Water Storage
All construction shall be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72)
3. The wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-
7904 (24 hours).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
Special Provisions: A copy of the encroachment permit to place absorption field fill in the right-of-way shall
be submitted to MOA On-Site prior to construction.
I Y 3/(/R-
Received
B : Date:
Issued By: ted,,,A ��L1/ Date: 02,27 77
�03L. 56289
MUNICIPALITY OF ANCHORAG F� G�►
•,fry
Community Development Department - Phone: 907-,r ' 7904
Development Services Fax: 907- a' 7
On-Site Water & Wastewater Program
Mayor Dan Sullivan
On-Site Sewer/Well Permit Application
For A Single Family Dwelling
Parcel I.D. 050-521-09
Property owner(s) MICHAEL CURTIS C/O DAVID CURTIS-SON Day phone (703)835-1174
Mailing address 12263 LAKE STREET, EAGLE RIVER,AK 995777
Site address CRYSTAL CREEK DRIVE (UNDEVELOPED ROAD), EAGLE RIVER,AK 99577
Legal description (Sub'd, Block& Lot) VALLEY VIEW ESTATES;TRACT 2
Legal description (Township, Section & Range)
Lot Size Sq.Ft. Number of Bedrooms 3
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DEWELLING:
(®all that apply) Initial ® Single Family(SF)
Absorption Field ® (w/wo ADU)
❑
Septic Tank ® Upgrade Duplex (D) n
Renewal
Holding Tank ❑ Multiple Dwellings ❑
Privy ❑ (SF and/or D)
Private Well
Water Storage n
THIS APPLICATION INCLUDES A VARIANCE/WAIVER REQUEST FOR:
SLOPE WAIVER/LOT LINE WAIVER Distance: 0 FEET/5 FEET
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal codes.
GARNESS ENGINEERING GROUP, Ltd.
(Signature of property owner or authorized agent)
Permit/Rush Fees: g(M-t 215 = /g9 Waiver Fees: 21 "
Date of Payment: oZ l 1 b l l 1 Date of Payment: 9,11 0 l 11
Receipt Number: 091 LV G Receipt Number: C `]'-1'76
Permit No. 05 62 V1 1° \ Waiver No. l73V f 1 OO(p
(Rev.01/11)
panics
GARNESS ENGINEERING GROUP, Ltd Ad'rtvtr,Trtystcvn
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CIVIL&ENVIRONMENTAL ENGINEERS - Dealer
February 20, 2017 (REVISED)
Municipality of Anchorage
Development Service Department
On-Site Water & Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
Ref: Proposed Well and Septic System for Valley View Estates S/D; Tract 2
To whom it may concern:
The proposed 3 bedroom house is served by a private well and septic system. Several
test holes have been excavated on the property. The proposed drainfield (primary site) is
designed around the 30 foot radius of Test Hole #3. We are proposing that a new 1000
gallon septic tank and dual 5-wide drainfields be installed for this property. Comments
regarding the design are summarized as follows:
1. SOILS: See the attached logs which show the soil classifications, groundwater
monitoring, and the percolation test results. For the primary site, we are proposing the
system be designed around TH#3 which had the percolation rate of 12 minutes/inch and
shallow bedrock at a depth of 6 feet. Based upon the percolation rate, the allowable
application rate for TH#3 is 0.8 gpd/sq.ft. For the reserve site, we are proposing the
system be designed around TH#1 which had a percolation rate of 10.9 minutes/inch and
shallow bedrock at a depth of 12 feet. Based upon the steep slopes; and the limited usable
area around the test hole (due to bedrock concerns), we are proposing the reserve site
use a Cat II advanced treatment system. The allowable application rate using a Cat II
advanced treatment system for TH#1 is 3.0 gpd/sq.ft.
2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications.
3. SURFACE WATERS: There were no surface waters noted within 100 feet of the
proposed septic system at the time of excavation of the test holes. However, with the
excavation/installation of the proposed driveway, the owner may potentially intercept
groundwater and cause it to daylight. A note has been placed on the design stating that
if this occurs, any surfacing water within 100 feet of the proposed septic system will need
to be routed subsurface.
4. TOPOGRAPHY AND SLOPE WAIVER: See the attached design and detail drawing
which shows the topography information based upon a Walatka & Associates plot plan.
As can be seen on these drawings, the proposed primary drainfields are to be installed
starting on/at a 35% slope that changes to a 25% slope. At the property line, the slope
3701 East Tudor Road, Suite 101 *Anchorage,Alaska 99507-1259
Phone: (907)337-6179*Fax: (907)338-3246*Website: www.garnessengineering.com
Page 2 of 2
changes to a 15% slope. These drainfields will have 2 feet of cover with 2 inches of
insulation and will have 3:1 slopes on the downhill and sides of the drainfield. The entire
mound will have topsoil placed over it and will be vegetated. Given the porosity of the
soils and the fact that the entire area below the drainfield will be vegetated, it is our
opinion that there is minimal risk with the installation of the primary site in regards to
slopes. The 3:1 slope will encroach into the undeveloped road right-of-way. We have
contacted Lynn McGee with the MOA Right-of-Way Department and have discussed the
proposed placement of fill in the right-of-way. He was receptive to the proposal and
requested a formal encroachment permit. The owner is in the process of obtaining the
encroachment permit. A copy of this permit will be supplied to you once it has been
issued.
In regards to the reserve site, we have place a note on the design drawing stating that
the reserve site will consist of the rebuilding of the primary drainfields.
5. LOT LINE WAIVER: As can be seen on the attached design drawing, we are
requesting a 5 foot waiver from the south lot line to the proposed drainfields. This waiver
is required in order to fit the proposed drainfield within the 30 foot radius of the test hole
and to fit it between the proposed driveway and the south lot line. The lot line abuts the
right-of-way, so neighboring property owners should not need to be notified.
We are unaware of any adverse impacts this installation would have on adjacent wells or
septic systems. If you have any questions, please contact us at 337-6179. Thank you
for your assistance.
.in -rely,,
Jeffs ij . carnes P.E., M.S.
Presi•:'
3701 East Tudor Road,Suite 101 *Anchorage,Alaska 99507-1259
Phone: (907)337-6179*Fax: (907)338-3246*Website:www.garnessengineering.com
•
'
/ I 1
VALLEY VIEW ESTATES S/13; 1 VALLEY VIEW ESTATES SID;
// VALLEY VIEW ESTATES S/D;��\
I l'/ TRACT 2 TRACT 3
TRACT I \
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...,..%-...,.::::� Y7 r • w 3.,::c�u?.z,L-..L�':; /v:,. �►� OWNER DUG HOgi LE •
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... • r.': aea U:, ::,/,2 •1;4.•:..c.�'.i.;.:::' I PROPOSED
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\` � � I WELL
320 -� ' �� N /. .. — — -----
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CRYSTAL CREEK DRIVE (UNDEVELOPED) ,
) / TH#3 0 _ 30'..--•
30' — ——-
PRIMARY DRAINFIELDS T
PROPOSED
SEE DESIGN;PAGE 1 OF 3
SEPTIC TANK
NOTE:ANY DAYLIGHTING OF GROUNDWATER THAT MAY BE
CREATED BY INSTALLATION OF THE ACCESS DRIVEWAY WITHIN VAVALLLLEY VIEW EST.S/D#1;
100 EST S THIS SEPTIC SYSTEM OR ANYUNEIGHBORING /- 'y BLOCK 1,LOT 5
SEPTIC SYSTEMS MUST BE MADE SUBSURFACE.
NOTE:TOPOGRAPHY
INFORMATION PROVIDED BY --
C.:-......WALATKA AND ASSOCIATESC ��
SEPTIC +�. _
VALLEY VIEW ESTATES S/D#1; AR J �'''' I \�`�
BLOCK 1,LOT 4 ///'
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ANCHORAGE,E.TUDOR ROAD,SUITE 101• AK 99507'PHONE(907)337-6179•FAX(907)338-3246'WEBSITE:www gemessengmeering.com •.
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: 0 S e• :y A.G8 s i 14.,• =
DAVID CURTIS 703-835-1174 1 OF 3 . j. • C -793 '�[_a
PROJECT/LEGAL DESCRIPTION: DRAWN BY: �♦�,�•••.• .0)
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TYPE OF WORK: DATE: REVISED LICENSE,I�1 1S'
SITE PLAN FOR PROPOSED WELL AND SEPTIC SYSTEM 2/20/2017 #AECC884 �����
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:1:.:..1.:: ---.--- 11.1.111..111.. -1:9-9:7-------......7::.::: : :" NOTE:THE CONTRACTOR OR OWNER L GEGEF i THATL td.HAS pE RAT8A1PNAsGTE TO
THIS SPECIFICATION DESIGN.T 0
....... • ;............. DESIGN CRITERIA: MUST HAVE THE WELL LOCATION,100 OBTAIN A COPY OF THE LETTER CONTACT
l'::::,..5..i6'........:• NUMBER OF BEDROOMS: 3 FOOT WELL RADIUS,AND THE SOUTH GEG.BY PROCEEDING FORWARD WITH THIS :
'•;"•••••••••••• GALLONS PER DAY(GPD): 450 LOT LINE FLAGGED/STAKED BY A INSTALLATION,THE ENGINEER,WELL DRILLER, I
••••• •••••••••••••••••• ... ' PERCOLATION RATE/S: 12 MIN./INCH(TH#3) REGISTERED LAND SURVEYOR PRIOR CONTRACTOR AND PROPERTY OWNER AGREE
.:: 1.
••••••••••••••••••••••.:. : PROPOSED APPLICATION RATE: 0.8 GPD/SQ.FT. TO ANY CONSTRUCTION. THAT THEY HAVE READ THESE
• • • • • - SPECIFICATIONS AND AGREE TO ACCEPT THE
:::-........:•.>.,... ..: • MINIMUM DRAINFIELD saFT.: 563 .., •.. ••, ••. •••• ••.. ••. •.,
... ... . . ... ..... ..........
;••••2••• ••:•,•'5• ,.• .., .,..., ... TERMS AND CONDITIONS OUTLINED. :
.•••• •'-•'•••••••••• DRAINFIELD DESIGN: I
....y''...17:6, .•••. • MAXIMUM EXCAVATION DEPTH:2 FEET @ •.:'•••.',....:•..... ".....:::-..,;................... ••••••,................., NOTE:THE RESERVE SITE , I- li
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•••• •'••....•' EFFECTIVE: 0.5 FEET
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CRYSTAL CREEK DRIVE (UNDEVELOPED) z
OWNER TO OBTAIN ENCROACHMENT PERMIT \
OF FILL AREA REQUIRED /
FOR 3-1 SLOPES
FROM MOA RIGHT-OF-WAY DEPARTMENT TO \
.
PLACE FILL IN RIGHT-OF-WAY --- — — ----"
NOTE:ANY DAYLIGHTING OF GROUNDWATER THAT MAY BE CREATED BY INSTALLATION I
OF THE ACCESS DRIVEWAY WITHIN 100 FEET OF THIS SEPTIC SYSTEM OR ANY SCALE:
NEIGHBORING SEPTIC SYSTEMS MUST BE ROUTED SUBSURFACE. I
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3701 E.TUDOR ROAD,SUITE 101•ANCHORAGE,AX 99507•PHONE(907)337-6179•FAX(907)338-3246*VVEBSITE:vnvw.gamessengineering corn 01:i. • .. : fter•
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DAVID CURTIS 703-835-1174 2 OF 3 0 0 . :
PROJECT/LEGAL DESCRIPTION: DRAWN BY: . ... E-7943 ..: ,..:
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VALLEY VIEW ESTATES SID;TRACT 2 J.L.M.
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TYPE OF WORK: •DATE: REVISED 44 ES-5k 44
LICENSE la III%%slim**
\.. DESIGN FOR PROPOSED WELL AND SEPTIC SYSTEM 2/20/2017 #AECC884 .1
i
DESIGN CRITERIA:
NUMBER OF BEDROOMS: 3
GALLONS PER DAY(GPD): 450
PERCOLATION RATE/S: 12 MIN./INCH(TH#3)
PROPOSED APPLICATION RATE: 0.8 GPD/SQ.FT.
MINIMUM DRAINFIELD SQ.FT.: 563
DRAINFIELD DESIGN:
MAXIMUM EXCAVATION DEPTH:2 FEET
WIDTH: 5 FEET HIGHEST POINT
LENGTH: 114 FEET(2 @ 57'LONG EACH)
M.O.A.APPROVED SAND FILTER: 2.5+FEET
EFFECTIVE: 0.5 FEET
ACTUAL SQ.FT.: 570
PROPOSED DRIVEWAY
,T •
CY w Mr • I 5.10SVOPE
W Z 3
ao-j T•3 ��"'ti` 4;
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SAND',,S, 2'DEEP
\�''''\. • 25"/o S y 6
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• \�//. • SLOPE./ice '/
/����, • IEolOQJC4 F BEDROCK AT 6 FEET
.D,EQp, UMEO
OWNER TO OBTAIN A
ENCROACHMENT PERMIT FROM
MOA RIGHT-OF-WAY DEPARTMENT
TO PLACE FILL IN RIGHT-OF-WAY
PRIMARY SITE PROFILE DETAIL DRAWING
SCALE:
F ,
1"=10'
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DAVID CURTIS 703-835-1174 3 OF 3 �.A�j- '. CE-793 i��• ��
PROJECT/LEGAL DESCRIPTION: DRAWN BY: . 431`...Q" Iri 137:**'(`:.
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LEGAL DESCRIPTION: VALLEY VIEW ESTATES S/D:TRACT 2 ♦1♦,�F•,,i id. j.*** C..
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PERFORMED FOR: DAVID CURTIS DATE: 9/6/2016 ♦♦♦ OFESS��P�♦♦
DEPTH - -�- #LICENS 4 ♦E I%%moms,*•
(feet)—; 6"-I' ORGANICS TEST HOLE #1
1 • •
• • SOIL CLASSIFICATIONS SITE PLAN
2 — , ,
3 — ORG
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• • GM / CL
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• • GROUNDWATER DATE ix./. c)1
• 5
8— ! ' DRY 9/6/2016
•
• DRY 9/13/2016SCALE.
•
1
9 * o0
•
•
10 '
• F
• CLOCK NET TIME WATER LEVEL NET DROP
11 — • DATE READING TIME (MINUTES) READING (INCHES)
12 R • 9/6/2016 1 3:28 6" -
FRACTURED 2 3:58 30 3-1/8" 2-7/8"
BEDROCK
13 — 3 3:58 - 6"
4 4:28 30 3-1/4" 2-3/4"
14 — 5 4:28 - 6"
6 4:58 30 3-1/4" 2-3/4"
15 —
16 —
17 — - — -------
18 —
PERCOLATION RATE 10.9 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
19 —
TEST RUN BETWEEN 5.0 FT. AND 6.0 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: IN YES ❑ NO
SOILS LOGGED BY:. JODY MAUS PERCOLATION TEST PERFORMED BY: JODY MAUS
COMMENTS: PERCOLATION READINGS ARE WITHIN 1/16 OF INCH.
PERFORMED BY GEG,Ltd. I,JEFFREY A.GARNESS,CERTIFY THAT THIS WASE?OC D IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: /
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LEGAL DESCRIPTION: VALLEY VIEW ESTATES S/D;TRACT 2 �.� T .•kms:.
PERFORMED FOR: DAVID CURTIS DATE: 9/6/2016 44� PROFESS\QN**.
DEPTH .----- #AECC884 ,11visss��
(feet)—._ 6"-I' ORGANICS TEST HOLE #2
1 . •
. SOIL CLASSIFICATIONS SITE PLAN
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GM J�� CL
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6 . . ML MIXED G
7 , * THROUGHOUT DEPTH TO •• P
GROUNDWATER DATE �l�,P N
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8 ! DRY 9/6/2016
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DRY 9/13/2016SCALE.
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FRACTURED DATE READING CLOCK NET TIME WATER LEVEL NET DROP
11 BEDROCK TIME (MINUTES) READING (INCHES)
9/6/2016 1 3:30 - 6" -
12 —
2 4:00 30 4-1/2" 1-1/2" I
13 — 3 4:00 - 6"
4 4:30 30 4-5/8" 1-3/8"
14 — 5 4:30 - 6"
6 5:00 30 4-5/8" 1-3/8"
15
16 —
17 — J
18 —
PERCOLATION RATE 21.8 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
19 —
TEST RUN BETWEEN 4.5 FT. AND 5.5 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: I. YES ❑ NO
SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: JODY MAUS
COMMENTS: PERCOLATION READINGS ARE WITHIN 1/16 OF INCH. __.
PERFORMED BY GEG, Ltd. I,JEFFREY A. GARNESS,CERTIFY THAT THIS WAS PEBFOMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: ./4 i 7
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SPE • ���♦.i
GARNESS ENGINEERING GROUP, Ltd •\*
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CIVIL&ENVIRONMENTAL ENGINEERS ... •
3701 E.TUDOR ROAD,SUITE 101•ANCHORAGE.AK 90507'PHONE(907)337 6179•FAX(907(3363246'INE0wvu ,g
51TE.ww.g "esserg"ancon, •. .
SOIL LOG - PERCOLATION TEST �# ,S
♦ �kf • CE 953 _*
LEGAL DESCRIPTION: VALLEY VIEW ESTATES S/D;TRACT 2 �. �•'•, J i ••(`�:•
PERFORMED FOR: DAVID CURTIS DATE: 9/6/2016 •44 ROFESS\U�•.
DEPTH :----- #A CC884 milk
(feet)- 6"-I' ORGANICS TEST HOLE #3
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. SOIL CLASSIFICATIONS SITE PLAN
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it • `?,`,a':, GW i::::::::::: ORG
GM TO ML
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3— ! • W& SOME GRAVEL 1022 GP ML
11:11191 GM W
CL
4 — ' • LENSES g��% GC OL VP�
OF SAND °°o°o o". SW jj( MH e
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R • IMR SM r' ,./; OH �O
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FRACTURED Q.
BEDROCK KS
7— DEPTH TO DATE P
GROUNDWATER ��(i (Nik
8— DRY 9/6/2016
DRY 9/13/2016 SCALE:
1 ,
9— r=goo.
10 —
NET DROP
11 — DATE READING CTIIME (MINUTES)ONET TIMEW READING LEVEL (INCHES)
12 — 9/6/2016 1 3:34 - 6" -
2 4:04 30 3-1/4" 2-3/4"
13 — 3 4:04 - 6" -
4 4:34 30 3-1/2" 2-1/2"
14 — 5 4:34 6" -
6 5:04 30 3-1/2" 2-1/2"
15 —
16 —
17 —
18 —
PERCOLATION RATE 12 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
19 —
TEST RUN BETWEEN 2.0 FT. AND 3.0 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: • YES ❑ NO
SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: JODY MAUS
COMMENTS: PERCOLATION READINGS ARE WITHIN 1/16 OF INCH.
PERFORMED BY GEG, Ltd. I,JEFFREY A. GARNESS,CERTIFY THAT THIS WAS PFR/FtMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: // 7
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MUNICIPALITY OF ANCHORAGE
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Community Development Department Phone: 907-343-7904
On-Site Water & Wastewater Program Fax: 907-343-7997
Septic System Owner-installer Agreement
A real estate property owner(Owner) may install their own septic system.
The department may issue an approval for a homeowner to perform work on a conventional
(not AWVVTS) on-site wastewater disposal system to serve that individual's owner-occupied,
single-family or duplex home if the homeowner satisfies and agrees to the following
requirements.
The property owner and excavation equipment operator may perform work on no more than
one owner installed project in a 12-month period.
As owner of (legal description) V 6' 1 /e i"e(✓ es Doifc_ T rK cKl agree the
following items are true and accurate.
1. My experience installing septic systems is as follows.
USA F Qnof h-dcphr r'cfeac OF 4,10/} Reju/ 1i 1f
Ootid rrati'n„"
2. The name of the excavation equipment operator is. Oo v,pd 6-c4rf''Y
3. There will not be compensation for installation services rendered.
4. I will be actively involved with the septic system installation at all times.
5. The name of the inspecting engineer is J r A. 676.ril ecr
6. I agree to discuss the following items with the inspecting engineer:
a. Permit design criteria and specifications.
b. Inspection requirements set forth in AMC 15.65.150.
c. 2-hour minimum advance notice given to the On-site Water & Wastewater
Program for all required municipal inspections.
7. I agree any changes I make to the items listed above will require a new approval before
performing work.
8. I agree to have the project-specific On-site Wastewater Disposal System Permit available
at the construction site)for the duration of all related work.
Owner's printed name: OCWI' OAr-/-1 S
Owner's signature: Date: 3 /Z//f�
Septic System Owner Installer Agreement_Feb2015.doc
POST IN A CONSPICUOUS PLACE 11A r r
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ALL WORK MUST BE INSPECTEDField Inspection Request required 2 working days in advance of starting work c and 2 working days in advance for final inspection. Call(907)343-8206 •4 4AgFp'��;,
(voice recorder) for scheduling. Permit is not valid without the call-in and also �, t Li El SGt�4
c, 4
must include the one-call ticket(utility locate)number. l e p r t men t
MUNICIPALITY OF ANCHORAGE
RIGHT OF WAY DIVISION
4700 ELMORE ROAD
TELEPHONE:(9017)3438240
RIGHT OF WAY PERMIT R171134
Type: Encrchmnt Grid: SW0263 Date Issued: 3/1/2017
Construction Start: Last Update by: PWMER
Last Updated: 02/24/2017
Permittee; MICHAEL CURTIS
Contact Person: David Curtis(Michael's son), 703-835-1174 Primary inspector: J.Sauerbrey 343-8044
Site Address: @ Crystal Creel Drve`&Mary.Ester Drive
Legal Description: VALLEY VIEW ESTATES TR 2 G:0263
Original Work ..ii:;.
•
Description: Encroachment of fill approx,26`into the urioeveloped'Crystal Creek Drive.ROW for length
of approxi 80', with maximum depth of fill at 4.2'on south property boundary tapering to 0.0' near
centerline of ROW.
Financial Summary •• ...::::.•,'
Fee Description ::, :.. .: . • .
Permit 1.00 . : `11.5;00 •
Total Fee : 115..00 ::
•: .''::=: :: •
See reverse for requirements/remarks.
I have read and understand both sides of this permit. I agree to the terms and conditions; and I certify that all work will
comply with federal, state, and municipal codes and regulations and the provisions of this permit.
i 57/ 1 //
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Signature: - Date: